Host Megan Hall sits down with Jared Perkins, director of health policy strategy at Brown University's Center for Advancing Health Policy through Research. They discuss how academic research makes its way from dense journals to policymakers on Capitol Hill, bridging the gap between science and legislation. Jared offers insights into the challenges of health policy under a shifting political landscape and explains how researchers can play a vital role in shaping decisions that impact healthcare nationwide.

Welcome to Humans in Public Health. I'm Megan Hall.

In the past few years, the field of public health has become more visible than ever before, but it's always played a crucial role in our daily lives. Each month, we talk to someone who makes this work possible. Today, Jared Perkins.

At universities all over the country, academics conduct research about how to improve our healthcare system. But how does their work actually get put into practice? A growing number of universities are starting to send people to Capitol Hill to bridge the gap between academics and policymakers. Today's guest, Jared Perkins, is one of those people.

Jared works for the Center for Advancing Health Policy through Research, sometimes called CAHPR, a part of Brown University's School of Public Health. Jared joined us in the studio to explain how research gets to policymakers, and offer an inside look into what health policy might look like under a second Trump administration.

Jared says academic research doesn't just magically appear in front of policymakers...

Researchers are constantly doing a ton of research and it's in different academic journals, right?

Those journals aren't easy to skim. They're dense and filled with academic language. But Jared says, if you look past all that, they contain important findings about how to improve health policy.

And so my hope is to bring all of those findings from the different academic journals, put them into one policy brief that really shows what they found and some of the policy recommendations they have related to that. So really trying to bridge that gap of like your wonky academic journal and bringing it into kind of terms that people can understand.

I was going to say, I mean, what person on the hill has time to read like a peer reviewed academic article or even dissect exactly what it means and how it applies to policy, right?

Yeah, they want clear and concise information in a short amount of time. I know a lot of people will say things move slowly in Congress, but when they need something from academics or from researchers, it's usually at a quick turnaround, right? They have to meet a deadline or something, and they want as much information in as short a time as possible. So it's a lot of trying to figure out how we can communicate our results in a way that's a good use of time to policy makers, um, and really showcases the expertise and the resources that we have.

I imagine it's sort of like how academics interact with journalists. I know that often if I called an academic and wanted information for a story, the story was coming out maybe that day or the next day and some of them wouldn't totally understand that and they'd say, Oh, I can talk to you in a week or let me send you some background information and I have to be like, no, no, no, no, no, no. I need a quote like now.

Yeah, yeah. And I think a lot of it is being able to do that quick turnaround too, but also like making it relevant to, to what the policymakers care about right? You think about a congressional audience, it's so diverse, members represent different parts across the country, they have different constituencies, whether they're rural or they're urban. So, really making the research relevant to what the members care about is extremely important in terms of having impact.

So I asked Jared how he actually does this work. Is he wandering the Capitol and knocking on Senators' doors?

No, I would say the, so every congress I identify the five key areas where I think Congress is going to move on health policy and then what five key areas of research that might be of interest to the hill and try to identify and line those up. But then it's a lot of paying attention. So it's really identifying those key members who are going to be interested in our work instead of kind of blindly going to offices who might not even be interested in healthcare. It’s a lot of, okay, who's on the committees, who's been working on this topic specifically, whether it's through legislation or writing letters or press releases about the topic, and kind of trying to develop relationships with those staff. Oftentimes when we're meeting with staff they're in like the beginning stages of even trying to figure out what kind of legislation to craft so you have to meet with them, inform them on the research and then they're like, okay, now we want to craft a bill. Then you have to go through all the politics after you have the bill crafted, right? You have to find co-sponsors, you have to find people across the aisle who might support your decision, and then you have to get those bills through committee, and then after you get those bills through committee, they’ve got to go through a floor vote. It can be a long extensive process.

Back in 2017 Jared was advising policymakers on a new bill, and it took *years* for that bill to be passed.

It was finally signed and passed into law in December, 2022. So it can take a while and a couple of congresses.

Recently some politicians have kind of encouraged a distrust of academics and a distrust of science. How much of that is bluster and how much of that is really changing on Capitol Hill? Are you noticing a difference or do people actually still want to cooperate with academics and researchers?

I believe there's still a want, especially at the staff level.

Jared says, every year, an organization called the Congressional Management Foundation conducts a survey of staffers on the hill.

And 99 percent of them said that they want access to high quality evidence based research, but only 32 percent of them felt like they had that access. So, to me, I always feel like there is a want and a need from staff. Every time I go to the Hill and meet with staff, they seem excited to meet with us, just because we're not coming in there telling them what to do. We're not, like, an advocacy organization trying to push them to do one thing over the other. We're kind of going in there and be like, “Hey. We have all this incredible expertise and resources. How can we help you make the best policy decisions?” and kind of empower them to, to really feel like that they have the resources and the expertise that they need to make sure they're making the right decisions on behalf of people.

So it's not like you have a researcher who just published a paper and then you're like pushing it on, on the hill and saying like, check out this new research. You're more saying, we are here for whatever policy you're working on to give you that perspective.

Yeah. We do do some of that proactive outreach as studies come out, they have huge findings to get them to policymakers.But we also want it to be a two way street, right? We also want to be meeting with staff to know, like what questions are they trying to get answered? So that way we can incorporate it in our research and that way our research is more relevant to what policymakers are trying to figure out and decide.

Republicans now have control of the presidency, House and Senate. So does this mean Republicans can make big changes to our healthcare policy?

When he says the margins, Jared's mostly talking about the budget. During something called budget reconciliation, the party in power can make changes with a simple majority vote. But these proposals can only cover financial decisions, things like taxes, spending, or the national debt. -- Jared thinks that's where Republicans might adjust health policy.

Yeah, I think the biggest one is going to be health care costs. I think in the election we saw the voters were concerned about the economy and the rising costs and health care affordability falls under that umbrella, right? And that's a lot of the research that's happening in the Center for Advancing Health Policy Through Research is how do we make healthcare more affordable, more accessible and have higher quality?

One option that policymakers seem interested in is creating something called site neutral payments. Right now, people on Medicare get billed different rates for the same procedure, depending on where that procedure happens. So it's much more expensive to get the same treatment done at a hospital than at a stand alone clinic.

So site neutral payments would bring those two equal.

This could do two things - it could bring down costs for people on Medicare, and allow Republicans to reduce spending, something they'll need to do to pay for Trump's tax plan.

So what other policy priorities are you seeing for 2025 besides cost?

Yeah, I think we saw healthcare policy in general kind of take a backseat in the election, but I still think there are going to be topics that are going to be top of mind for policymakers. Something that doesn't go away for policy makers each year is the opioid crisis. I think the Congress last year was supposed to get the SUPPORT Act reauthorization, which was this big comprehensive bill to address the opioid epidemic that was passed a while ago. Those programs are up for expiration. So now they need to reauthorize that.

So what would you say to people who have seen that Republicans have campaigned against science in some cases, were against vaccinations during the COVID pandemic, and you know, don't seem to be in support of some of the health policy that researchers are looking into and might be worried. Should they be worried? Are there going to be big changes to the way healthcare happens in this country?

Yeah, I try to keep a positive outlook because it helps me on a daily basis. I definitely think there's always cause of concern, but we just don't know what's going to happen and so until we know, it's really hard to say. I always look to the House and Senate Appropriations Committees, because, right, these are the committees that fund the government every year, and when you think about major reforms to like NIH or CDC in terms of funding, those are the committees that have jurisdiction over that. And the leadership of those committees have always been very pro-science and pro-NIH on both sides of the aisle, and there's been a lot of bipartisanship around that. So that gives me some optimism and hope that there won't be huge significant cuts to NIH funding.

Speaking of people who are skeptical of science and health policy, I have to ask you about RFK Jr., who Trump has nominated to be the Secretary of Health and Human services. Do you think he's actually going to become the Secretary? What are you hearing?

It's hard. The nomination process is going to be a long process, right? He's got to go through confirmation hearings. Anything can kind of happen in those confirmation hearings. And then after they get through those hearings, he's got to pass with a simple majority in the Senate. And again they have a slim majority, so it may make it a little bit more difficult. I don't like guessing sometimes on like whether he's gonna get passed or not because it's so hard to say right now until we get through the confirmation hearings. I think that's something republicans and Democrats have both always said is that we’ve got to give them a hearing before we make a decision.

But let's just assume that he does get confirmed. How much power would he have to shape health policy? And um, what do you expect to see from someone who's a vaccine skeptic?

I think you look at kind of rules and regulations, right? If you're going to pay attention to what an RFK HHS would do. The rules that HHS are proposing are really going to be a strong signal to that. I think when the president's budget drops in March, that'll also be a very strong signal of what some of their priorities are. So for me, I'm going to be looking at those to just get a sense of like what they plan to do. And on the other hand, it's more looking at how they can shift staff, right? Are you going to see a lot of career people get kind of shifted around just under the new administration? People who are in leadership might be moved to different positions. So seeing who they bring in underneath RFK Jr., I think is as important as say RFK Jr.'s appointment itself, right? Those people are going to be shaping the different centers and the different administrations underneath HHS.

So do you think that, um, a lot of this sort of anti science rhetoric is more sort of performative or overblown?

I think in some sense, but I also do think it is, if they're talking about it, that means they want to try to do something about it, right? So I think there is a reason to have some cause of concern. Um, I don't know if like, I would say hit the panic button just yet, but I do think there, but I think I always try to remember that there are safeguards in place that keep them from, like, just kind of pushing through Congress. So I try to keep some optimism in that sense.

Jared Perkins, I want to thank you so much for joining me.

Thank you so much for having me. I really appreciate it.

Jared Perkins is the Director of Health Policy Strategy at the Center for Advancing Health Policy Through Research at the Brown University School of Public Health

Humans in Public Health is a monthly podcast brought to you by Brown University School of Public Health. This episode was produced by Nat Hardy and recorded at the podcast studio at CIC Providence.

I'm Megan Hall. Talk to you next month!